Sugarman Health and Wellbeing - Watford

Assessment activity took place between 7 January 2026 and 2 February 2026.

Sugarman Health and Wellbeing - Watford is a domiciliary care agency providing nursing and personal care to people with complex clinical needs living in their own homes. Some people were living with a learning disability, but this was not their primary care need. At the time of our assessment 40 people were supported.

This was a focused assessment of the key questions safe and well led to follow up on breaches found at our last inspection. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

This was a remote assessment completed by 1 inspector. We received feedback from 21 staff, 5 professionals, 2 people who use the service and 11 relatives. At our last assessment, in June 2025, we rated the service requires improvement. The provider was previously in breach of the legal regulation in relation to safe care and treatment and good governance. Improvements were found at this assessment. However, the provider remained in breach in relation to good governance.

The provider’s processes to monitor the quality and safety of the service were not fully embedded for effective oversight. They had not always identified where staff had not completed records as required.

The provider had made improvements to communication and information sharing at the service. Some people and staff felt there was still room for improvement with this; some staff felt supported, but others described issues with communicating with the office and not always feeling listened to.

The provider trained and assessed staff as competent. Some people and staff did not always have confidence in staff skills; the provider planned to engage with people via an independent nurse to help resolve this.

People’s care plans and risk assessments contained some inconsistencies but included personalised information for staff to meet their individual needs. Their medicines were managed well. The provider had systems and processes to safeguard people from the risk of abuse. They worked well and shared information with other professionals involved with the service.

The registered manager was responsive to feedback where improvements were required.

We have written to the provider to ask for an action plan about how they will improve the quality and safety of the service where there were breaches of regulations.

Sugarman Health and Wellbeing - Watford is a domiciliary care agency providing nursing and personal care to people with complex clinical needs living in their own homes. Some people were living with a learning disability, but this was not their primary care need. At the time of our inspection 34 people were supported. This was a comprehensive assessment covering all key questions and quality statements completed between 3 April and 7 May 2025. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. We identified breaches in regulations in relation to staff competency, medicines management, managing risk, and governance.

The provider had not ensured staff were competent to provide care and treatment safely and people’s medicines were not always managed well. The provider had not ensured people’s care was provided in accordance with their care plans. People’s care plans and risk assessments contained some inconsistencies and staff had not completed records well.

The provider worked with other professionals and people were supported to access other services as required. People’s capacity assessments to consent to care were not always completed correctly.

Staff treated people with kindness and understood their communication needs. The provider collected information on people’s cultural needs and social interests and people were supported with activities. People were supported to maintain their independence. The provider had not always promoted staff wellbeing; some told us they did not feel supported.

People’s care records were personalised, and they received care from regular staff. The provider had dealt with concerns people and their relatives raised and no formal complaints had been received.

The provider’s systems and processes to monitor the quality and safety of the service were not always effective. The registered manager was responsive to feedback where improvements were required. Staff did not all feel supported in their roles with some describing issues with communication with the office team. The registered manager had not always identified actions and shared learning from incidents.